Parent - Counseling Survey
Thank you for taking a moment to fill out the following survey. I will use the Information you provide to support you and your student(s) this year and to plan Counselor Coffee Chat sessions.
What is your name?
Your answer
If you have any concerns about your child(ren) and would like them to be included in a small group (ex. friendship, social skills, divorce/family transitions, loss, etc.) or individual counseling please provide some info here including child name and topic.
Your answer
I am going to start a monthly "Counselor Coffee Chat" for parents. I will be covering various topics. Are there any specific topics that you would like to learn about? If so, please list them below. *
Your answer
Do you have any other specific questions for me?
Your answer
Thank you so much!
I am excited to dive into my counseling program at PUE and I really appreciate you taking the time to give me insight on any needs or concerns I should address. Please feel free to reach out to me at any time with any concerns or ideas.
Jordan Smith
School Counselor

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